Portal pyaemia secondary to open haemorrhoidectomy: Need for prophylactic broad spectrum antibiotics

Raghunath Prabhu, Arjun Natarajan, Sunil Krishna, Siddharth Thangavelu

Research output: Contribution to journalArticle

Abstract

A 70-year-old man presenting with long standing grade 3 Haemorrhoids, underwent open haemorrhoidectomy under spinal anaesthesia. The patient passed stools on subsequent day and there was no bleeding per rectum. On day 5, he complained of dull aching upper abdominal pain. On physical examination, the abdomen was soft and there was mild tenderness in the epigastric region. Subsequently, he developed high temperature with chills and rigors. His condition failed to improve and the abdominal pain increased in severity. There was no pain in the perianal region and per rectum examination was normal. Leucocyte count rose to 12×109/L and there were toxic changes on peripheral smear. Blood culture grew Staphylococcus aureus. Liver enzymes were mildly elevated. Coagulation profile was deranged. Fibrin degradation products were positive. D-dimer was high. CT revealed acute thrombosis of left portal vein and microabscesses suggestive of portal pyaemia.

Original languageEnglish
Article number200222
JournalBMJ Case Reports
DOIs
Publication statusPublished - 27-06-2013

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Hemorrhoidectomy
Rectum
Abdominal Pain
Sepsis
Anti-Bacterial Agents
Fibrin Fibrinogen Degradation Products
Hemorrhoids
Chills
Spinal Anesthesia
Poisons
Portal Vein
Leukocyte Count
Abdomen
Physical Examination
Staphylococcus aureus
Thrombosis
Hemorrhage
Pain
Temperature
Liver

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Portal pyaemia secondary to open haemorrhoidectomy: Need for prophylactic broad spectrum antibiotics",
abstract = "A 70-year-old man presenting with long standing grade 3 Haemorrhoids, underwent open haemorrhoidectomy under spinal anaesthesia. The patient passed stools on subsequent day and there was no bleeding per rectum. On day 5, he complained of dull aching upper abdominal pain. On physical examination, the abdomen was soft and there was mild tenderness in the epigastric region. Subsequently, he developed high temperature with chills and rigors. His condition failed to improve and the abdominal pain increased in severity. There was no pain in the perianal region and per rectum examination was normal. Leucocyte count rose to 12×109/L and there were toxic changes on peripheral smear. Blood culture grew Staphylococcus aureus. Liver enzymes were mildly elevated. Coagulation profile was deranged. Fibrin degradation products were positive. D-dimer was high. CT revealed acute thrombosis of left portal vein and microabscesses suggestive of portal pyaemia.",
author = "Raghunath Prabhu and Arjun Natarajan and Sunil Krishna and Siddharth Thangavelu",
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Portal pyaemia secondary to open haemorrhoidectomy : Need for prophylactic broad spectrum antibiotics. / Prabhu, Raghunath; Natarajan, Arjun; Krishna, Sunil; Thangavelu, Siddharth.

In: BMJ Case Reports, 27.06.2013.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Portal pyaemia secondary to open haemorrhoidectomy

T2 - Need for prophylactic broad spectrum antibiotics

AU - Prabhu, Raghunath

AU - Natarajan, Arjun

AU - Krishna, Sunil

AU - Thangavelu, Siddharth

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Y1 - 2013/6/27

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